Karen Young believes in doing anything she can to care for her pets – even if that means driving 2,000 miles for treatment. Recently, Young, her brother-in-law, Ron Lehman, and Young’s dogs, Tartufo and Milagros, traveled from Mountain View, Calif., to treat Tartufo’s cancer at the University of Missouri Veterinary Medical Teaching Hospital.

Tartufo, or Tufo, as Young calls her 9-year-old mixed-breed dog, initially had his apocrine gland anal sac adenocarcinoma removed surgically in December 2012. When the cancer returned in October 2013, Young and her veterinarian decided to get a second opinion from Dr. Jeffrey Bryan, associate professor of oncology at the MU College of Veterinary Medicine. Bryan had been Young’s veterinarian several years earlier when he lived in California and also had been a classmate of her current veterinarian, Dr. Jenny Taylor. In addition, Bryan had a good record of success treating aggressive cancers like Tufo’s, Lehman said.

Bryan and Taylor recommended radiation treatment for Tufo, and though Young initially feared it would be too hard on her dog, discussions with both doctors made her confident it was the right decision.

Next Young had to pick a veterinary hospital for Tufo’s radiation. Her previous history with Bryan, plus his experience treating cancer, led to her decision to make the trek to Columbia.

Young said she wasn’t familiar with any of the veterinarians at the nearest veterinary hospital and wanted Tufo to be treated by someone she knew would provide outstanding care.

“A personal relationship with a vet is really important,” Young said. “I just felt more comfortable with somebody I knew.”

Tufo’s cancer was surgically removed in California in November, and after a four-day drive the group arrived in Columbia to meet with Bryan and tour the VMTH.

Lehman said the presence of veterinary students was a benefit. Students ask interesting questions, he said, which can lead to innovation.

Linear Accelerator Improves Cancer Care

Tufo received 18 treatments using the MU Veterinary Medical Teaching Hospital’s new linear accelerator, a powerful tool in the fight against cancer. The machine, a remanufactured model that came from a hospital that treats humans, is the most advanced veterinary radiation therapy system in the Midwest, said Dr. Jimmy Lattimer, associate professor of veterinary medicine and surgery.

Tufo received 18 daily treatments using the VMTH’s new linear accelerator. The machine allows veterinarians to tailor radiation to the tumor’s shape and depth, thus minimizing harm to surrounding tissue.

Bryan said veterinarians generally aim for a “magic window” of three to five weeks of radiation treatment.

“Typically we want to spread it out because it’s more effective at killing the tumor while minimizing side effects,” he said.

Technology like the linear accelerator has greatly improved cancer treatment. Although 10 years ago he would have been skeptical that Tufo’s cancer could be treated safely and effectively, Bryan said, the treatment went very well. Tufo experienced only moderate skin side effects and had almost no side effects in concerning organs such as his colon.

Bryan said he expected Tufo would need no further treatment for at least two years, whereas the tumor probably would have recurred within a couple months without the radiation.

He said anal sac tumors can cause severe problems because they grow in an area where space is limited and can prevent the dog from being able to eliminate urine and feces. Many dogs don’t receive the treatments they could get for these tumors, which tend to respond well to surgery and radiation therapy, Bryan said.

Although Bryan admitted it’s unusual for a client to travel so far, he said he knew the VMTH could provide Young both excellent care and excellent communication.

“They wanted the best for this dog,” he said. “It’s always an honor to provide our very best for our patients. I knew that the team here could provide the care and communication that Tufo and Karen needed.”

In an email Young sent recently to Bryan and Taylor, her veterinarian in California, she praised the care she received.

“Thank you both for making it possible for us to look forward to a cancer-free future,” she wrote. “As I told Dr. Jenny yesterday, the memories of Tufo’s suffering are already receding as he heals and we are left with the good memories of feeling very safe and totally supported while he underwent his baptism by fire.”

Although Tufo’s radiation treatment “wasn’t a walk in the park,” he is now fully recovered and very happy, Young said.

“I think a large part of my being able to go through with it was the complete confidence I have in Dr. Bryan,” she said. “I think that if it had been at another facility where I didn’t have such good communication, I might have given up when the going got tough, but I am so glad I didn’t.”

Linear Accelerator Improves Cancer Care

Tufo received 18 treatments using the MU Veterinary Medical Teaching Hospital’s new linear accelerator, a powerful tool in the fight against cancer. The machine, a remanufactured model that came from a hospital that treats humans, is the most advanced veterinary radiation therapy system in the Midwest, said Dr. Jimmy Lattimer, associate professor of veterinary medicine and surgery.

“Like anything, it’s not 100 percent (effective),” he said. “But even for human medicine it would be considered pretty much state-of-the-art.”

Before beginning radiation, CT scans and sophisticated new software allow faculty and residents to create a 3D representation of the tumor that helps identify the best angles of approach. The linear accelerator then targets tumors with a beam of radiation tailored specifically to the tumor’s shape and depth. The ability to fine-tune the radiation dose means less normal tissue is irradiated and surrounding organs are avoided.

Although the hospital previously had a linear accelerator, this newer model allows veterinarians to more accurately and quickly target tumors. One of the biggest improvements is its multileaf collimator, Lattimer said. Whereas the old system had four collimator leaves, the new system has an additional 80 collimator leaves that are independently moveable below the four leaves. By manipulating the individual leaves, the beam is tailored precisely for the tumor.

“It’s a safer machine, it’s more accurate and it’s more flexible than the old machine was,” Lattimer said. “We can shape the beam much more delicately than before, and it allows us to do the treatments much more quickly.”

In addition, because less radiation is applied to the surface of the animal, it is less harmful to its skin, said Dr. Jeffrey Bryan, associate professor of oncology.

Veterinarians at the teaching hospital are using the linear accelerator primarily to treat dogs and cats with cancer that can’t be remediated by surgical or medical means.

Radiology technician Jeff March said the effects of the linear accelerator on patients with brain tumors can be remarkable to watch.

“A lot of times when you see them they’re so clinically affected they’re like zombies,” he said. “There’s no life to them. And then after we treat them they come back to life. They turn back into the dogs they were to begin with. You get to see a flower bloom, essentially, as they come back to life and respond to treatment.”